NEW SCHOOL ENQUIRY

Please complete ALL questions before you submit your enquiry. If Not applicable please enter NA

Q1. What region / area is your school located?

Q2. Name of School

Q3. Suburb where your School is located

Q4. Does this request have support of the Principal

Please answer the following questions about your school's breakfast program (or proposed program):

Q5. Are you seeking support for a 'new' or 'existing' breakfast program?

Other

Q6. How many mornings a week would your school like to run a breakfast program?

Please Note: Schools who can only run a breakfast program once or twice a week (i.e. less than 3 days) may not be eligible for direct deliveries* or loan of large equipment). *At this stage the YMCA is only able to deliver supplies directly to schools located in Logan, Ipswich, Brisbane, Moreton Bay Regions. We are planning for Redland Bay region

Q7. If your school can only run its breakfast program one or two mornings a week, will your school be able to collect food supplies from Logan or a neighbouring school (if avail as an option)?

Other

Q8. Estimated number of students who will attend your breakfast program per day?

Q9. How long will the breakfast program run for each morning:

Q10. Where will your school run their Schools' Breakfast Program - example at within or near Tuckshop, hall kitchen, staff lunch room, special education unit, class room, hall, undercover area etc. Please explain your best option.

Q.11 What access and visibility will the breakfast program have (select all that apply):

Other

Q12. Who will the breakfast program be open to:

Other

Q13. How long does your school intend to run a breakfast program?

Other

How should we contact you?

Other

Q14. Does your school currently receive any 'donations of food' for its Breakfast program? If so, please list the type of food below and who donates them (N.B. This will not disqualify you from receiving for support from the Y).

Q15. Does your school receive any Funding $ specifically for its Breakfast Program? If so, please enter below the $ amount received each year (enter NA or 0 if zero). N.B. This will not disqualify you from applying for support from the Y.

Q16. Please provide information that demonstrates the School's need for a Breakfast Program. The YMCA Schools' Breakfast Program does use the ICSEA values however we understand there are other reasons a school requires support. Please provide a short outline on why your school would like to have our program to support your children and familes.

Q17. Do you have a team of volunteers or teachers to assist you with running the breakfast program? (Ideas to consider are local community groups, head of grade or subject, Social Science, faculty, staff, families, student leaders, house captains, prefects, etc. )

Other

Comments

Your Full Name

Your position or role

Your Email

Your Email:

example@example.com

Your Phone Number

Q18. How did you hear about the YMCA Schools' Breakfast Program?

Other

Privacy Statement

YMCA is gathering the information on this form to be able communicate with you and make necessary arrangements for the activities of the YMCA School's Breakfast Program. If you do not provide this information, then we may be unable to offer this program to your school. The information will be stored securely in YMCA systems located with Australia. The YMCA will not share your information without your express permission unless required to under law or to comply with court process. Should you wish to access to update your contact details or communication preferences, please contact us at breakfast@ymcaqueensland.org.au

The Y Schools' Breakfast Program